| NPI | 1679632772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071001870) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071001870) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |